Family issues are common in daily life, and the impact of illness and health on family has been researched in various contexts. In Japan's primary care settings, many patients face family problems. One approach proposed to address these issues is "family-oriented care." Family-oriented care is based on "systems theory" and "family therapy" and involves collaborations between family physicians and family therapists. Although several previous studies have discussed its practice and effectiveness, standardized training programs have yet to be established, leaving each facility to refine its approach through trial and error. Furthermore, limited literature exists on the current state of education in this field, making it difficult to grasp the overall landscape. This review article provides an overview of the current status of family-oriented care practice and education in Japan, compares it with advanced efforts in the U.S., and discusses challenges in standardizing education in Japan. Furthermore, we propose the development of a standardized education model for "Japanese-style family-oriented care," tailored to Japan's unique cultural context, customs, family dynamics, and societal structures.

This study investigated the physiological responses and effects of exercise training under hypoxic conditions at the skeletal muscle level induced by reducing muscle temperature in cold water environment. Participants were divided into two intervention groups, cooling and control conditions, according to the water temperature of 15°C and 33°C where the training were conducted in. Eight participants in each group performed submaximal cycling exercise in the water for 30 minutes at the lactate threshold (LT) intensity, three times a week for four weeks (12 sessions). LT intensity was assessed at pre- and post-intervention in a 33°C water temperature environment. A progressive load cycling test was performed on land to assess maximal oxygen uptake (VO2max) and Wingate test was conducted to measure anaerobic power. In the cooling group, working muscle deoxygenation increased during submaximal and maximal exercise, suggesting an improvement in the muscle oxygen extraction capacity. However, no effects on aerobic capacity such as VO2max or LT intensity were observed. The improvement in mean power and time to peak during the Wingate test in the cooling group indicated that LT intensity exercise training in a cold water environment would increase anaerobic power.

　As psychological, behavioral, and social factors have a significant impact on health and illness, approaches to these factors are important in medical practice. From the perspectives of global standards of medical education, medical curricula with emphasis on behavioral and social sciences are necessary. The behavioral and social science contents of medical education in the U.S. include six domains: mind-body interactions in health and disease, patients' behavior, physicians' role and behavior, physician-patient interactions, social and cultural issues in health care, and health policy and economics. We need to develop educational outcomes, strategies, assessment, and faculty development to incorporate behavioral and social sciences into medical curricula in Japan.

The Consensus of this Committee is:

1) To change the name of the present committee from "Premedical Education Committee" to "Committee on Behavioral and Social Science" ; accordingly to discuss theoretical foundations, clinical application, learning objectives and outcomes of behavioral and social science in Japanese medical schools.

2) To collect actual case studies of teaching behavioral and social sciences in Japanese medical schools and create a database for such practices.

3) To develop behavioral and social science curriculum content in Japanese medical schools.

4) To organize training courses for teaching methods for behavioral and social science curricula and develop standardized teaching methods and materials.

  Emotional intelligence and empathy are crucial in patient–physician relationships and clinical outcomes. It has been reported that both emotional intelligence and empathy decrease as students advance through medical school. This study aimed to validate Japanese versions of the Trait Emotional Intelligence Questionnaire–Short Form （TEIQue–SF）, developed by Petrides and Furnham （2001）, and the Jefferson Scale of Physician Empathy （JSPE）, developed by Hojat et al. （2001）.
1）The TEIQue–SF and JSPE were translated and administered to 370 medical students. Valid responses were obtained from 321 students（88%）.
2）Cronbach’s alpha for internal reliability was high for both the TEIQue–SF （0.87） and the JSPE （0.89）. All item total score correlations were positive for both the TEIQue–SF （range, 0.29 to 0.64） and the JSPE （range, 0.27 to 0.72）.
3）Cronbach’s alpha was smaller if an item was deleted than if all items were included for both the TEIQue–SF （0.84–0.85） and the JSPE （0.81–0.86）.
4）Factor analysis of both the TEIQue–SF and the JSPE revealed that the Japanese versions had some structural differences from the original versions. However, criterion–related analysis showed that the TEIQue–SF and the JSPE were highly correlated with the NEO–Five Factor Inventory, a measure of the Big Five personality traits.
5）These findings provide support for the construct validity and reliability of the Japanese versions of the TEIQue–SF and the JSPE when used for medical students. Further investigation is needed.

1)In medical education in the United Kingdom, departments of general practice organize the basic training in clinical skills and specialty training in primary care.
2)A clinical clerkship in primary care is a compulsory 5–week subject, as are clerkships in internal medicine, surgery, pediatrics, obstetrics/gynecology, and psychiatry.
3)As a tutorial training system has been established, general practitioners are contributing to medical education as clinical instructors.

BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.

BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.

The Medical Education Development Center has organized seminars and workshops for medical education 30 times from 2000 through 2008 throughout Japan. The participants have numbered more than 3200 and have included educators, physicians, students, and simulated patients. The topics of seminars and workshops have included problem-based learning tutorial systems, medical interview skills, objective structured clinical examinations, evidence-based medicine, coaching technology, simulations, and community medicine in response to educational needs. A questionnaire survey of 1793 participants of the 11th to 30th seminars and workshops (response rate, 85.6%) showed a high degree of satisfaction (4.33±0.13 of 5 points). Invited lecturers and directors from throughout the country often organized these workshops. The results of workshops are reported in our annual monograph, "Trends in Medical Education."